LINCOLN — Katie Dearing, 30, of Omaha enrolled at the College of St. Mary three years ago, intent on a career in health care. Though medicine always appealed to her, medical school seemed out of reach to the military wife and mother of two girls, ages 10 and 12. She instead decided to become a physician assistant.
It's a high-demand, good-paying profession, one of the fastest-growing in Nebraska and the nation. Because it requires fewer years of training and promises a more predictable work schedule than for doctors, it's also a good fit for older students with family responsibilities, like Dearing.
Yet Nebraska has only two physician assistant training programs, with room for a combined 80 students per year. This year, nearly 600 applicants will be turned away from the master's degree programs of the University of Nebraska Medical Center and Union College in Lincoln.
Seeing an opportunity, officials at the College of St. Mary in Omaha decided to launch the state's third physician assistant training program. It will begin accepting undergraduate students this fall. The program will integrate both undergraduate schooling and the master's level training necessary to become a physician assistant. It will predominantly admit students who have not yet earned a bachelor's degree, although some exceptions may be made, particularly for alumni.
The training bottleneck the College of St. Mary is trying to help overcome is part of a national phenomenon, said Constance Goldgar, incoming national president of the Physician Assistant Education Association.
At the top of the funnel are students like Dearing, seeking to gain a foothold in a career that pays, on average in Nebraska, $86,529 per year, according to Nebraska Department of Labor.
At the other end is expanding demand. Federal health care reform and the aging baby boomer generation bring more patients into the health care system, exacerbating the shortage of primary care providers.
The College of St. Mary plans to train 24 students a year in its physician assistant program. The program will be limited to female students because the private Catholic college serves women only as undergraduates.
Meanwhile, the medical center program, established in 1974, and Union College program, established in 1997, both have increased their student numbers during recent years.
The medical center program expanded from 40 to 50 students over the past three years, and Union College has increased from 25 to 30 students.
The medical center also plans to establish a satellite training program at the University of Nebraska at Kearney in 2015, with a goal of annually training 16 to 20 new physician assistants in central Nebraska.
“There's been a call among the physician assistant profession that we would nationally increase enrollment by 30 percent to meet the anticipated growth in the need for primary care,” said Michael Huckabee, director of the medical center program.
Officials at both the medical center and Union College are in the midst of interviewing candidates for next year's class.
Both programs are highly competitive, requiring high grade-point averages and a résumé of activities to demonstrate career interest, leadership and a strong work ethic. Only a third of medical center applicants make it to the interview stage, and less than 10 percent of Union College's applicants are accepted.
“We get applications from all across the country — and we take people from everywhere,” said Michelle Buller, clinical director of the Union College program.
The College of St. Mary is among about 50 colleges across the country now developing physician assistant programs, according to the Accreditation Review Commission on Education for the Physician Assistant.
Other colleges seeking to accredit new programs include Boston University, Ohio State, Penn State and the University of Missouri-Kansas City.
Over the past two years, 15 new programs have opened nationally, putting the total of existing programs at 170.
No new programs are under way in Iowa, which has two existing training programs, at the University of Iowa and Des Moines University.
Christine Pharr, vice president of academic affairs for the College of St. Mary, said officials began discussing a physician assistant training program about a year and a half ago.
“We constantly look for new program ideas for the state and the region,” she said. “There's certainly a need, particularly in rural areas, for more nurses, doctors and PAs.”
Dr. Jeff Keyte is a physician and an assistant professor of biology at the College of St. Mary. He has helped develop the college's human biology curriculum, which will form the foundation of the new program.
Aging baby boomers, retiring physicians and federal health care reform will increase demand for the services of primary care doctors, Keyte said.
Physician assistants help primary care doctors serve more patients, Keyte said.
Dr. Michael Zaruba, a 12-year family practice physician in Auburn, Neb., said physician assistants can help rural doctors avoid burnout.
His office of five doctors employs three full-time physician assistants and one part-time PA who conducts a women's wellness clinic once a month.
In an unusual strategy, the full-time physician assistants are assigned to emergency room duty at the local hospital, freeing the doctors from being on call 24 hours a day, seven days a week.
They handle most of the sporadic emergencies in the town of about 3,500, but call in doctors for the most serious cases.
“I like to call them physician extenders,” Zaruba said. “It keeps you fresh and able to deal with the things that require a physician's training.”
Though physician assistants often are thought of as primary care providers, they can be deployed in a variety of settings, from hospitals to specialists' clinics, said Keyte.
It's a field increasingly dominated by women, Pharr noted.
“It's a great career for women,” she said. “That's a good living for a five-year degree.”
Angie Baumert, a first-year student at the medical center, said her interest in becoming a physician assistant was sparked after she had knee surgery in 2007 as a high school senior.
“I spent a lot more time with the PA than I did with the doctor,” she said. “He was so involved and caring; he went out of his way to be helpful.”
The predictable work schedule and the shorter time to complete the degree also appealed to the 23-year-old.
“I don't have to go to school as long as a doctor, and my loans aren't going to be as big as theirs,” she said.
The new College of St. Mary program will be an accelerated five-year program that results in a bachelor's degree in human biology and master's-degree level physician assistant training.
The college expects to graduate its first physician assistants in the spring of 2018.
A key difference in the College of St. Mary program is that it will admit most students as freshmen and promises them a seat in the upper-level physician assistant classes if they keep up their grades.
Other programs were developed as stand-alone training for students who already hold bachelor's degrees. Students must compete for one of the few coveted seats — and might have to change their career plans if they can't get in.
Dearing, whose interview at the med center is scheduled for early January, admits she's a little nervous about making the cut.
“Yes, there's definitely the fear there,” she said. “This is what I've been working toward the past three and a half years and it's very competitive.”
She graduates in May with a bachelor's degree in biology and a minor in chemistry. She also worked as a medication aide and did a research project to develop an elementary school science outreach program.
She has applied at both the med center and Union. If she's not admitted this year, she plans to keep trying until she is accepted somewhere.
“I have no plans of backing down,” she said. “This is something that I plan to do.”
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